Our inspections are EVERY SINGLE YEAR here in the Keystone State (even on a
ONE YEAR OLD from factory NEW car!!), and we ourselves FULLY pay for the draconian privatized inspection AND registration fees EVERY YEAR.
The 'twice' thing is swapping out the illegal pipe for the legal one for the inspection, and then swapping back in the illegal one.
The state also mandates that the car MUST BE lifted up and inspected for all emissions equipment, and that at least two diagonally opposing wheels be removed and pads/axle seals be inspected,
regardless of miles on the car.
Then the car must be test driven by one of the 'techs', and it is up to the shop's policies/discretion (and liability insurance I am guessing) as to whether or not the customer can ride along for this 'test drive'.